MEDICARE: SONALI MEHTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080A0000X	Pediatric Adolescent Medicine Physician	MD435772	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225148505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONALI MEHTA MD

Provider Business Mailing Address
First Line	:	3045 PENNSYLVANIA AVE
Second Line	:	SUITE 3
City	:	WEIRTON
State	:	WV
Zip	:	26062-3770
Country	:	US
Telephone Number	:	304-723-4000
Fax Number	:	304-794-7100

Provider Business Practice Location Address
First Line	:	3 ROBINSON PLZ
Second Line	:	SUITE 100
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-1024
Country	:	US
Telephone Number	:	304-723-4000
Fax Number	:	304-794-7100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	01/06/2015

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Directions to “ SONALI MEHTA MD” Practice Location

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